Blood test, average blood sugar (A1c)
Facility: Pratt Regional Medical Center
Billing Code: 83036 (CPT)
- CPT Billing Code: 83036
- Insurance Median: $52
- Cash Discount Price: $43
- vs. Medicare Baseline: 5.36x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $9.71 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Elevated Commercial Rate Alert (Value-Gap)
The negotiated rate at this facility is 536% of the Medicare baseline (a markup of 436%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Christian Health Aid | $33 - $59 | 340% |
| Health Partners Of Kansas | $37 - $66 | 381% |
| UnitedHealthcare | $37 - $80 | 381% |
| Aetna | $40 - $70 | 412% |
| Choicecare | $44 - $78 | 453% |
Consumer Guidance & Cost Commentary
For this blood sugar test (A1c) at Pratt Regional Medical Center in Pratt, KS, the cash median price is $43.00, which is lower than the facility's gross charge of $61.00. While the facility's negotiated rates with major payers like UnitedHealthcare and Aetna range from $37 to $80, these amounts are often higher than the cash price due to administrative costs and contract structures. Patients with high-deductible plans may find it financially advantageous to pay the cash price directly, as the $43.00 rate is significantly lower than the negotiated amounts insurers typically pay. It is important to note that while the facility is in-network for these payers, the cash rate remains the most transparent baseline for comparison.
To ensure you are not overcharged, always request a detailed itemized bill before paying, as summary invoices can hide unbundled codes or services not rendered. If you receive a balance bill for an out-of-network service, remember that the No Surprises Act generally protects you from paying the difference between the provider's full rate and your insurance allowed amount for emergency or non-emergency care at in-network facilities. Additionally, ask the billing department about prompt-pay discounts, which can further reduce the final cost if you settle the account upfront. Comparing this $43.00 cash rate to the state average provides a clear picture of fair pricing, helping you avoid unexpected debt and make informed decisions about your healthcare spending.